04379 (SFD)A, 1 ,
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 52`565 nomu as -LA QUINTA, CALIFORNIA 92253
Owner
Jahn Vela Jr.
Mailing
Address
City Zip Tel.
Contractor
8 amc
Address
Tel.
State Ljc. Ii.# 458 -
& Classif. 337559 Lc
Arch., Engr.,
Designer
Address Tel.
City( Zip I
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under Provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, after• improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code• or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than rive hundred dollars ($500).
❑ I, as owner of the properly, or my employees with wages as their -sole compensation, will
do the work, and the structure is not intended or offered for sale.'(Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
1 �}
r
Datel2-.� r F Owner : ✓!h '�'� 1 i } f•�1/.
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
O Copy is filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit Is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
(j,N•I
BUILDING: TYPE CONST. • OCC. GRP.
A.P. Number 773--305-1015
Legal Description
Project Description S. F • D.
. 04371
1
WHITE - FINANCE,PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
Sq. Ft. 1330
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑
Demolition ❑
8981 Garage
Estimated Valuation
$74,681
PERMIT
AMOUNT
Plan Chk. Dep.
$250.00
Plan Chk. Bal.
Const.
X58.00 <•
Mech.
36.00 t
Electrical
73.22 '
Plumbing
105.00
S.M.I.
5.22
Grading
20.00
Driveway Enc.
20.00' .
Infrastructure
r
TOTAL
42r ti.',iq . U7
r
REMARKS
Yat LY1.:Y! .t tix�tcr..
..,....•....
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
7/28 88
Issued by: Date Permit
Validated by:
Validation:
1
WHITE - FINANCE,PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES ....�
ISI FL. SO FT rp S
UNITS
SLAB GRADE —
ROUGH PLUMB BONDING
YARD SPKLR SYSTEM
2ND FL SO FT.q
FORMS
EWER OR SEPTIC ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR SO F -T a
GAS (ROUGH) G F�METER LOOP
. HEATING (FINAL)
OUTLET
ROOF DRAINS
GAR SO. FT. aPOWER
y
GROUT
DRAINAGE PIPING
CAR P. 50 FT. a
FINAL INSP.
WALL SO. FT. Ia
WATER SYSTEM
DRINKING FOUNTAIN
GRADING
cu. yd.
$ plus z$
_$
URINAL
50. FT. fd
FRAMING
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
67
FOUL r T
�N
6INSULATIONISOUND
WATER PIPING
NOTE: Not to be used as property tax valuation
-
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTONDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
&dl NAL INSPECTION
SO.FT.GAR @ 3/ac
HOUSE SEWER
CERT. OCC.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
kc -SETBACK c—,12 �
ROUND PLUMBIpS — UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE —
ROUGH PLUMB BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
EWER OR SEPTIC ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) G F�METER LOOP
. HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL G _
AS (FINAL)// TEMP. POLE
/
y
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus z$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
//��teROOFING _
67
FOUL r T
�N
6INSULATIONISOUND
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR*
GAR. FIREWALL
LATHING
MESH
1 — r
v�
FINISH GRADING
&dl NAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
W-11
BUENA ENGINEERS, INC.
17A A Walter Street
VENTURA, CALIFORNIA 93003
1W
DAILY FIELD REPORT
GRADING
JOBNo. or P.O. No.
J` a
� h
-7 -0.7 I
r2 !
PAGE
l or l
ECT NAME
h
CLIENT OR OWNER
DAILY FIELD REPORT SEQUENCE NO.
RAL LOCATION OF WORK
F
OWNER OR CLIENT'S REPRESENTATIVE
DATE
91IJ
DAY OF WEEK
7-.A
ERAL CONTRACTOR
r-T4Tr r (!,-III-T4-
GRADING CONTRACTOR
PROJECT ENGR.
YPE OF WORK
TYPE
J1, ' I 1�- P"_.I
GRADI NG CONTRACTOR'S SUPERINTENDENT OR FOREMAN
SUPERVISOR
SOURCE AND DESCRIPTION OF FILL MATERIAL
WEATHER
A, "r
TECHNICIAN
a1f e>
KEY PERSONS CONTACTED (Civil Engr., Architect, Developer, etc.)
TEST TEST LOCATION,
NUMBER
Wl
FIELDTESTING REFERENCECURVE
ELEVATION DRY MOISTURE % OF COMP. MAXIMUM OPTIMUM COMMENTS
DENSITY CONTENT MAXIMUM CURVE DRY MOISTURE
lbs./Cu. ft. / DRY NO DENSITY CONTENT
DENSITY lbs./cu. ft.
--3 omi=t' zt= I
SGS. /v. -7 9,-J
DESCRIBE EQUIPMENT USED FOR HAULING, SPREADING, WATERING, CONDITIONING, AND COMPACTING.
NOTES: (Describe work completed during the day;
.,any
,.problems and their solution) �r _J-
PEir�i-t.art,¢�t" n.r p- /r�i�.i G� �--Sr�1Cfti( �•*I 7�• .���i<-r,....c.�..-ti
Av�r
GTS! ,'Yi'!.''C 4�C���
/✓/ L� / /117.�t -[�[-t�^-Gt- �^T� �G�-c'ff<
u
CONTINUED I I
WHITE COPY TO OUR FIELD FOLDER
CANARY COPY SENT TO CLIENT f_1
PINK COPY TO PROJECT ENGINEER
COPY GIVEN TO:
REPORT BY:
DAILY FIELD REPORT
r
j Building
Addres
` OwnPr ` ,
LJ o ,, y � I/1
3Tavl :3 +rAp
's��:2N0? —_--�
-
-% P.O. Box 1504j �� � - — - : APPLICATION ONLY -- - '
i 78-105 CALLE ESTADOlei
LA QUINTA, CALIFORNIA 92253 ,
_ 77; - 3 0-J
Mallin _ _. BUILDING: TYPE CONST. OCC. GRP. -
9 -� � r i
I Address J A.P.-Nurriber
J City
(
Legal Descriptio -
_ Project Description 61 a � I•a '" t64
n ✓N G�
City Zip Tel..
State Lic. City _ '
8 Classif. 3 �� �, Lic. # �� - Sq. Ft. J 3D No. No. Dw.
Size- -Stories - Units
Arch., Engr.,
Designer New t Add ❑ Alter ❑ Repair ❑ - "Demolition ❑
4 Address Tel. 1 ,
City Zip State - - - - -
Lic. #
t
IACENSED CONTRACTOR'S DECLARATION
I hereby affirm t ' f I a licensed under rovI Ions, of Chapter 8 (commencing with Section .
7000) of Division lot t usiness an P feselons Code, and my license Is In full force and
, effect. , ),..:
. L
—
i
1 1
DATE
I
OWNER• UILDER DECLARATION
I hffirdn that I am exempt from the Contractors License Law for the following
ere
reason: (Sec. 7031.5,Busihess and Professions Code: Any db' or county which requires a
any structure, prior to Its Issuance also _
_ pgrmh to construct, alter, Improve, demolish, or ad statement
-requires �Nen of tint ►n�ctto��ense�law"Keeper 9 (Commen�g with Sectition�7000) of
--b stn 3l Business M�1�auon oosectionma7031 he s by'a'anty�q�ilcani for crebasis
pe
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will
-do the work, and the structure is not Intended or offered for sale. (Sec. 7041, Buisness and
Code: The Contractor's License Lew does not appy to an owner o1 property who
_ builds or improves thereon and who does such work himself or through his own employees,.-Mech.
provided that such Improvements are not Intended or offered for sale. if, however, the building
or Improvement Is sold within one year of corrIoletlon, the owner-bu9der will have the burden
• of proving that he did not bolo or improve for the purpose of sale.) .. .
Estimated Valuati
l 11
(/
PERMIT
- ... -
- - AMOUNT
Plan Chk. Dep.
p - --
Plan Chk. Bal.
'Z S
Const.
-+" — ..
_ _ 6
co
Electrical
73 , Z.Z
Plumbing
0 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law -
-does not appy to an owner of property who builds or Improves thereon, and who contracts for
-S.M.I.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
-❑ 1 -am exempt under Sec -- ti P.C.-tor this reason -
GradingQG
Driveway Enc.
,. , ev
Data—)owner r ' f -
Infrastructure - '---
- - - -
-
- ms's - -
- � - - -
�WORKERS' COMPENSATION DECLARATION f
J hereliy',effinn that I have a certificate of consent to self -Insure, Ora certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sac. 3800, Labor Code.)
,
_..Policy No Company
`
❑ Copy is flied with the city. ❑ Certified copy Is hereby furnished.
-
-
TOTAL
S
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
-{Ttda section need not be completed n the permit Is for aro hundred dollars ($100) valuation
or less.)
_ 1 certify that in the perfomtano of,th@ work for which this permit Is Issued, I shall not
=any rson In any manngr so As,to become subj to the Workers' Compensation
_ laws of Caufarrda.
Date_ Owner tI -!_ j
_NOTTCEE =_APPLJCANT. It, after makkp M CertNlcate of Exemption you should become
sub)ect to-the^1Mmlrers' CorrMensation provisions of a tabor Code, you must forthwith
_com* with such prov or this permit shall be deemed revoked.
^ JQ P9117 0?-Q2-R.R
U CASH O
ZONE:
Minimum Setback Distances:
BY: - - — - - --
I
Front Setback ffom` Center Line — -
Rear Setback from Rear Prop. Line -- -
W -
-__. _-=NSTAUCTION LENDING AGENCY
Side Street Setback from Center Line
hereby affirm that there Is a construction lending agency for the performance of the
workfor winch this permit Is Issued. (sec. 3097, Civil Code.)
-- -
Side Setback from Property Line
Lender•s.-Name
Lender's Address
This Is a building permit when properly filled ont-signed amid validated, and Is subject to
expiration If work thereunder is suspended for 180 days.
- I certify that I have read this application and state That theabove Information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
-construction, and hereby authorize representatives -of -this city to enter the above-.-
mentlaned property for Inspection purposes E
-- —^- ---
FINAL DATE
Issued by:
Validated by:
INSPECTOR
-- - --
Date Permit.
Signature of applicant Date
-#failing Address--- - - - - -- -- - -
-Validation:-,- -
- - - r
--- ---- — - —
City, State, Zip
BUILDING DIVISION
Building
Address
T4hf
�� SME s�- 9a s ula,ttar�
P.O. BOX 1504 APPLICATION ONLY
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Owner
J /
" a HAI �/ FG tl
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number -7 7 3'. -
Mailing
Address
City
Zip
Tel.
?
Legal Description
Project Description S. /—r r
Contractor
Address
City
Zip
Tel..
State Lic.
City
& Classif. �j 7 G j
Lic. # Y(
Sq. Ft. 2No. No. Dw.
Size I f 3 0 Stories - Units
Arch., Engr., i
Designer �.
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip -
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Susiness and Professions Code: Any city or county which requires a
permit to construct, after, Improve, demolish• or repair any structure, prior to Its Issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions or the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he Is exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penally of not more than five hundred dollars ($500).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such improvements are not Intended or offered for sale. If, however, the building .
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep. 5 O , Q Q
Plan Chk. Bal.
Const.
Mech.
Electrical '
Plumbing
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec. B. 8 P.C. for this reason
S.M.I.
Grading
Driveway Enc.
Dale Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
O Copy is filed with the city. O Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
REMARKS r rc n , ren e i
j A 17 AA, � �( � I1TAl
Date Owner
NOTICE TO APPLICANT: It, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Side Street Setback from Center Line
Side Setback from Property Line
Lender's 'Name
FINAL DATE INSPECTOR
Lenders Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
1 agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-.
mentioned property for inspection purposes.
Issued by: Date Permit
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
BUILDING DIVISION
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
SLAB GRADE
2ND FL. SO. FT. ®
BONDING
YARD SPKLR SYSTEM_
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SO. FT. ®
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APP./EQUIP.
DRINKING FOUNTAIN
SQ FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
I
IKITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
I TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/a c
SEWAGE DISPOSAL
GAR. FIREWALL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
MESH
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-X$-=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS,
GARDEN WALL FINAL